频域光学相干断层扫描和扫描激光检眼镜对视神经纤维层成像的比较。

Comparison of retinal nerve fiber layer imaging by spectral domain optical coherence tomography and scanning laser ophthalmoscopy.

机构信息

Department of Ophthalmology and Visual Sciences, The Chinese Uniersity of Hong Kong, Hong Kong, People’s Republic of China.

出版信息

Ophthalmology. 2011 Nov;118(11):2196-202. doi: 10.1016/j.ophtha.2011.03.035. Epub 2011 Jul 16.

DOI:10.1016/j.ophtha.2011.03.035

PMID:21762989

Abstract

OBJECTIVE

To compare the area and the angular width of localized retinal nerve fiber layer (RNFL) defects imaged by confocal scanning laser ophthalmoscopy (CSLO) and optical coherence tomography (OCT) and to evaluate their agreement.

DESIGN

Cross-sectional study.

PARTICIPANTS

Fifty-one eyes of 41 glaucoma patients.

METHODS

Sixty-one distinctive, localized RNFL defects (17 superior and 44 inferior RNFL defects) detected in RNFL photographs imaged by a CSLO were identified. These patients underwent RNFL imaging with a spectral-domain OCT. The RNFL thickness deviation maps (50×50 pixels) generated by the OCT revealed the locations of abnormal RNFL thicknesses with abnormal pixels denoted in red (RNFL thickness less than the lower 99% normal distribution) or yellow (RNFL thickness less than the lower 95% normal distribution). The RNFL thickness deviation maps were aligned and overlaid with the corresponding CSLO RNFL photographs. The area and the angular width of RNFL defects from the corresponding retinal regions in the CSLO RNFL photographs and the OCT RNFL thickness maps were measured and compared. Their agreement was analyzed with the Bland-Altman plot.

MAIN OUTCOME MEASURES

The area and the angular width of RNFL defects and the agreement of RNFL defects measurements between OCT images and CSLO RNFL photographs.

RESULTS

The area and the angular width of RNFL defects measured with the CSLO RNFL photographs were 1.11 ± 0.57 mm² and 23.80 ± 10.38°, respectively, which were significantly smaller than those measured by the OCT RNFL thickness deviation map when abnormal RNFL thickness was defined as less than the lower 95% centile ranges (2.27 ± 0.92 mm² and 74.16 ± 28.74°, respectively; both P < 0.001). When abnormal RNFL thickness was defined as less than the lower 99% centile ranges, a significant difference in angular width (42.11 ± 22.19°; P<0.001), but not in area (1.19 ± 0.68 mm²; P = 0.444) was found between the 2 imaging methods. Bland-Altman plots revealed that a larger RNFL defect was associated with a greater difference in angular width between OCT and CSLO RNFL photography measurements.

CONCLUSIONS

The agreement of RNFL defect measurements between CSLO RNFL photography and OCT was poor. The OCT RNFL thickness deviation map could reveal additional RNFL abnormalities not detectable by CSLO RNFL photography.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

摘要

目的

比较共焦激光扫描检眼镜（CSLO）和光学相干断层扫描（OCT）成像的局限性视网膜神经纤维层（RNFL）缺损的面积和角度宽度，并评估它们的一致性。

设计

横断面研究。

参与者

41 例青光眼患者的 51 只眼。

方法

在 CSLO 拍摄的 RNFL 照片中识别出 61 个独特的局限性 RNFL 缺损（17 个上方和 44 个下方 RNFL 缺损）。这些患者接受了光谱域 OCT 的 RNFL 成像。OCT 生成的 RNFL 厚度偏差图（50×50 像素）显示了异常 RNFL 厚度的位置，用红色（RNFL 厚度小于 99%正常分布下限）或黄色（RNFL 厚度小于 95%正常分布下限）表示异常像素。将 RNFL 厚度偏差图与相应的 CSLO RNFL 照片对齐并叠加。测量并比较 CSLO RNFL 照片中相应视网膜区域的 RNFL 缺损的面积和角度宽度，以及 OCT 图像和 CSLO RNFL 照片之间的 RNFL 缺损测量值的一致性，并通过 Bland-Altman 图进行分析。

主要观察指标

RNFL 缺损的面积和角度宽度，以及 OCT 图像和 CSLO RNFL 照片之间 RNFL 缺损测量值的一致性。

结果

CSLO RNFL 照片测量的 RNFL 缺损面积和角度宽度分别为 1.11±0.57mm²和 23.80±10.38°，当异常 RNFL 厚度定义为小于 95%百分位数范围时，明显小于 OCT RNFL 厚度偏差图测量值（分别为 2.27±0.92mm²和 74.16±28.74°；均 P<0.001）。当异常 RNFL 厚度定义为小于 99%百分位数范围时，两种成像方法之间的角度宽度存在显著差异（42.11±22.19°；P<0.001），但面积无显著差异（1.19±0.68mm²；P=0.444）。Bland-Altman 图显示，较大的 RNFL 缺损与 OCT 和 CSLO RNFL 摄影测量值之间的角度宽度差异较大有关。